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Case Report: Acute Splenic Artery Thrombosis in a COVID 19, Postpartum Patient
Sebastian Daniel Trancǎ1,2, Oana Antal1,3, Anca Daniela Farcaş4,5
1Surgery Department, "Iuliu Haţieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Insights
COVID-19 increases thrombotic event risk in pregnancy. A case report details a pregnant patient with COVID-19 who developed splenic artery thrombosis and infarction despite anticoagulation.
Area of Science:
- Obstetrics and Gynecology
- Infectious Diseases
- Hematology
Background:
- Pregnancy is a hypercoagulable state, increasing thrombotic risk.
- SARS-CoV-2 infection (COVID-19) is associated with a high incidence of thromboembolic disease.
- The combination of pregnancy and COVID-19 raises concerns about heightened thrombotic event risk.
Observation:
- A 31-year-old pregnant woman (26 weeks) with severe COVID-19 pneumonia presented with no prior medical history.
- During her illness, she developed a massive splenic infarction.
- Splenic artery thrombosis was identified as the cause of the infarction.
Findings:
- This case highlights a rare splenic artery thrombosis and infarction in a pregnant patient with COVID-19.
- The event occurred despite the patient being on a therapeutic anticoagulation regimen.
- Arterial thrombotic events, though less common than venous events in COVID-19, can occur.
Implications:
- This case underscores the complex coagulopathy associated with COVID-19 in pregnancy.
- It suggests that even therapeutic anticoagulation may not fully mitigate thrombotic risk in all severe cases.
- Further research is needed to understand and manage thromboembolic complications in pregnant COVID-19 patients.
Abstract:
The incidence of thromboembolic disease is reported to be high in SARS-CoV2 disease. Pregnancy, an already physiologically hypercoagulable state, associated to COVID 19, generates even more concern regarding the potentially increased risk of thrombotic events. The exact incidence of such complications is yet unknown, but there is data suggesting that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Since the outbreak of the COVID 19 pandemics, the most common described thrombotic events associated with SARS-COV2 infection have been venous thromboembolism and disseminated intravascular coagulation, while arterial thrombotic events are less commonly described. Splenic infarction is a rare disorder that can be secondary to a hypercoagulable state. There are only few cases of splenic infraction described, but none with splenic artery thrombosis, in a post-partum patient, on therapeutic anticoagulation regimen. We present the case of a 31-year-old Caucasian, 26 weeks pregnant woman, with no prior medical history, admitted to the hospital with a severe form of COVID 19 pneumonia and who, during the course of the disease, developed a massive splenic infarction with splenic artery thrombosis.
